Kushala Abeysekera: Acid-Base Handling

 

A.     Metabolic Acidosis

B.     Metabolic Acidosis with respiratory compensation

C.     Respiratory Acidosis

D.    Respiratory Acidosis with metabolic compensation

E.     Metabolic Alkalosis

F.     Respiratory Alkalosis

G.     Fistula

H.    Pneumonia

I.      Respiratory alkalosis

J.      Hyperventilation

K.    Renal failure

L.     Hypokalaemia

M.   Diabetic Ketoacidosis

 

1.     A 22yr old female medical student presents with palpitations, dizziness and peripheral tingling. ABG results: pH 7.55; pCO2 2.0kPa; pO2 15kPa. Her friend informs you that Professor Meeran and walked past the patient and she had been breathing heavily ever since.

 

2.     A 28yr old professional footballer presents with feeling generally unwell. The patient was currently on Doxacycline for a recent Chlamydia infection. Tests: Creatinine 300; Urea 11; pH 7.30; pCO2 2.0kPa; pO2 15kPa; H+ 126nmol/l; Bicarbonate 14mmol/l. What is the diagnosis?

 

 

3.     A portly gentleman arrives in A&E with vomiting and signs of dehydration. His wife accompanies him and describes symtoms of polydipsia prior to presentation. Blood results: pH 7.33; pCO2 2.0kPa; pO2 16kPa; H+ 130nmol/l; Bicarbonate 6mmol/l; Glucose 56mmol/l. What mechanism has occurred here?

 

4.     32yr old gentlemen with known CrohnÕs Disease presents with abdominal pain, ÔgooeyÕ stools, has complained of diarrhoea recently and is concerned this is another flare. Your reliable 5th year medical student has examined the patients and commented on his low respiratory rate (8). The gastroenterologists perform a colonoscopy and find the patient to have a fistula in his ascending colon. After 4 hours the 5th year student has finally interpreted the blood results and believes the patient is in metabolic alkalosis. What is the cause?

 

5.     A 48yr old smoker presents with shortness of breath, fever and chest pain. Examination of the patient reveals consolidation in the left lower lobe. Your medical student tells you the patient is hypercapnic and in Type II respiratory failure – what is the acid-base balance?

 

 

Answers:

1 – F, 2 – K, 3 – B, 4 – L, 5 – C